Permit w _
C ITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00616
,,srl^ DEVELOPMENT SERVICES DATE ISSUED: 10/20/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S104BD -00401
SITE ADDRESS: 13735 SW WALNUT LN
SUBDIVISION: ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Replace electric furnace with gas, electronic air cleaner, gas to furnace, reconnect A/C lines
Owner: - FEES
SUSAN PEINKOFER Description Date Amount
13735 SW WALNUT LN [MECH] Permit Fee 10/20/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 10/20/03 $5.80
Phone: 503- 975 -5838 Total $78.30
Contractor:
ALL METRO HEATING INC
PMB 120 2870 NE HOGAN RD STE E
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone: 503 - 381 -4557 Mechanical Insp
Final Inspection
Reg #: LIC 152937
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -00
Issued By: Permittee Signature:
Call (5 3) 6394175 by 7:00 P.M. for inspections needed the next business day
•
ii
1V FOR OFFICE USE ONLY ONLY ec�anical Permit Application Received Mechanical
Date/By: (03.0(03 Permit No Q ..,XO2, Co/ (o
Planning Approval Building
City of Tigard Date/By Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
/Gi e o r l„ ((fA
Contact Case No.:
Internet: WWW.CI.tlgard.Or.t1S el I Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information.
• . TYPE OF WORK ..COMMERCIAL FEE* SCHEDULE - USE CHECKLIST.
p New construction ❑ Demolition Mechanical permit fees* are based on the total value of the•work
J Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
'CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
2 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ yloo • See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: • Heating/Cooling
JOB SITE INFORMATION and LOCATION - Furnace - add -on air conditioning•• / 14.00 /N. °iC'
Job site address: /3335 sw +^)�l^"t i.,...r-iy >rd, 0P. 9 }=2.3 Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
Project Name: Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: ¢ rofe.. Q. W. (for radiator or hydronic system) 14.00
Coo tra1.412 o waA'.,►F S6. } 135 1,1„, A.ia.. (,, c ._ Unit heaters (fuel, not electric)
D ^ t 3 514,. 3 l akL.Q ,-.• ena..L R ;NI...4 0 .to (in wall, in -duct, suspended, etc.) 14.00 00
W...4 L" eo.s1ls,.s.s- Z '151,o,3<s dpw^ es", Q 1 S�A - Flue/vent (for any of above) / 10.00 g to.
Subdivision: I Lot #: Repair units - 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
/, [API C/scl'r t Fs) r no.GA. w / G e.< Po rA0,GL Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
2. 5,.,s l E .1.4e c A.; G l;.a.•-�r Wood/Pellet stove 10.00
3. .-,,,.c11-6,.. I I G a. S pL . - 6 ,A 5 'bo Sat el F.) e ^A.C• a- • Wood fireplace/insert 10.00
r f • l a ` ,,,,. A . J .. 0 . Alt (,,.. f .gy Co.1o.•r. G..11, Chimney/liner /flue/vent 10.00
® PROPERTY OWNER I ❑ TENANT Other: • 10.00
Name: Environmental Exhaust & Ventilation
5 0Sati p �
T Range hood/other kitchen equipment 10.00
Address: / 3 7.3 S 5 ti.) L.-Jo-IA.' 1 l... . Clothes dryer exhaust . 10.00
City /State /Zip: -' ', a rcj O it q i. Z Z 3 Single duct exhaust
Phone: C6 -o ;0 ei 3-6 5838 Fax: (bathrooms, toilet compartments,
❑ APPLICANT ll ® CONTACT PERSON utility rooms) 6.80
Name: q-301„,..., SA....d r jr Attic/crawl space fans 10.00
Other: 10.00
Address: eq.() 6, L.•. , • Fuel Piping
City /State /Zip: P r-i . 0 e 4 7- z z C * *($5.40 for first 4, $1.00 each additional)
Phone: is-63) 3 8 4/53 I Fax: C Sa 3) z13..• 0 � Z Furnace, etc. / •' s. y°
Gas heat pump ••
E -mail: 6 }_ Sa .,.a e Sur€ iza. -s, . mr Wall/suspended/unit heater ••
' CONTRACTOR Water heater *•
Business Name: A 11- M t,' re 144.44.4: 3 /,. c. Fireplace ••
Address: pµ3 rec. , z8go Ne N014^ ti .04. E Range ••
BBQ 4.*
City /State /Zip: 6 re-S L. , o,e q -} 0 3 o Clothes dryer (gas) • •
Phone: Cs'a1) 3g /- 4 4 - 5 - 4•I Fax: LS'a3) zg * - 634 Other: •*
CCB Lic. #: /5 ci 31- Total: _
Mechanical Permit Fees*
Authorized
\ Date: / c ' % 3 Subtotal: $ -q . 40 Signature: n , C�� Minimum Permit Fee $72.50 $ f) a , 50
0.,.. �� ' c ISur Plan Review Fee (25% of Permit Fee) $ s
(Please print name) State Surcharge (8% of Permit Fee) $ S . 8b
TOTAL PERMIT FEE $ $ , 3 - 0
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri- County Building Industry Aervice Board.
180 days after it has been accepted as complete. "Site plan required for exterior A/C units.
i :\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard _ t
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total V „ • •.Perci►it
$1.00 to $5,000.00 Minimum fee $72.50
$5,001 00 to $10,000 00 $72.50 for the first $5,000.00 and $1 52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional 5100 00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up . $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations Per Appliance:.'; -
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil 2,310
BTU
30 -50 hp; absorb. unit, 3,400 •
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
iMsts\Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
-BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / x- AM PM BUP
Location /373.5 Waln Suite _ 3 " 4D(°/
Contact Person i • ^ Ph ( ) 38I 1 4S37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Ftg
Foundation Access: ✓'�
9 �/� ELR
Crawl Drain
Slab Inspection Notes: i �/t ` , SIT
Post & Beam `(X Vic, I.
Shear Anchors & ' /�- l
C—
Ext Sheath/Shear l�`•~ -+ �'S
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall 41.11111111.11.1111....—
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof - - - -/ V\ 06-1 L k 3,
Other: `^�
Final mil` �� RZ7 `ci 6CN
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab -
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P SS PAR FAIL
ECHANICAL r / yam
• & rseam I 2237 —� `;•. �-.� .� � / 97 / 7
e
Smo e Dampers
Ina
RT FAIL
EL AL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA Ext
Date 10 � 7`0__ Ins actor `?
Approach/Sidewalk p
Other:
Final DO NOT REMOVE this Inspection cord from the Job site.
PASS PART FAIL